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Robert Prudhomme

Appendix IX of the WCR: The Autopsy Report

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After receiving assistance from "two Daves", I have found a way to get around my inability to c/p material from JFK's autopsy report, found in Appendix IX of the Warren Commission Report. I was stymied by this appendix being placed in a pdf file at the National Archives, but the "two Daves" managed to find it in a more accessible form at JFK Lancer. (thanks for printing out the whole pdf, Greg. Good to give folks a chance to read it)

http://www.jfklancer.com/autopsyrpt.html

Below is the pertinent paragraph which I will be referring to:

"Dr. Perry noted the massive wound of the head and a second much

smaller wound of the low anterior neck in approximately the midline.
A tracheostomy was performed by extending the latter wound. At this
point bloody air was noted bubbling from the wound and an injury to
the right lateral wall of the trachea was observed. Incisions were made
in the upper anterior chest wall bilaterally to combat possible
subcutaneous emphysema. Intravenous infusions of blood and saline
were begun and oxygen was administered. Despite these measures
cardiac arrest occurred and closed chest cardiac massage failed to
re-establish cardiac action. The President was pronounced dead
approximately thirty to forty minutes after receiving his wounds."

Within this paragraph is one very pertinent sentence:

"Incisions were made

in the upper anterior chest wall bilaterally to combat possible
subcutaneous emphysema."

I'll let this sit with everyone until tomorrow, and give everyone a chance to do a little reading on "subcutaneous emphysema". While you are reading about it, and keeping in mind the condition of JFK, as presented to Parkland physicians, ask yourself the following questions:

1. Is subcutaneous emphysema a life threatening condition?

2. How long does severe subcutaneous emphysema take to develop, especially if the patient has had limited respiration since the onset of the development of the condition?

3. Would ER surgeons, confronted with a non-breathing pulseless patient, take the time to relieve subcutaneous emphysema prior to performing other life saving measures?

4. How is subcutaneous emphysema normally treated, if not so severe as to interfere with normal respiration?

Subcutaneous_Emphysema_1-506x671.jpg

Subcutaneous-Emphysema.jpeg

Two photos showing patients displaying widespread severe subcutaneous emphysema, originating from leakages in their pleural cavities. Is this how JFK's appearance was reported at Parkland Hospital? Is this how JFK is seen in the autopsy photos?

Edited by Robert Prudhomme

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Robert,

An excellent thread. The passing of the blame onto the Parkland doctors - especially Malcolm Perry - just shows how Humes worked. He knew very well when that report was written that JFK was not suffering from subcutaneous emphysema.

I understand that what happened was that after the Autopsy, Commander Humes made two phone calls to Malcolm Perry in Dallas. The first was an exploratory call to see what had been done. It was during this call that Humes was informed about the neck wound. This was when he discovered that what he had thought was a tracheotomy, was indeed one - but also one cut over an existing wound. Something Humes had not been aware of. The second call was quite specific and was about the Chest Tubes. Malcolm Perry referring to this call said he (Humes) subsequently called back and inquired about the chest tubes, and why they were placed and I replied in part as I have here. It was somewhat more detailed. H6 16

When the Autopsy report came to be written, although the use of chest tubes was acknowledged, their purpose had been changed. The report stated that Incisions were made in the upper anterior chest wall bilaterally to combat possible subcutaneous emphysema. CE 387 2 Humes use of language is really interesting. Homes uses the adjective "possible. He knew very well the real reason why the chest tubes had been inserted. However the use of this word covered him and allowed the suggestion to be made that there was an anterior reason why the tubes had been employed. The report did not reflect that the real reason Parkland had decided to use them which was because they feared the right lung had been damaged.

When Malcolm Perry was interviewed by the HSCA he was asked about the Autopsy reports description of why the Chest Tubes had been used. He replied: Its interesting to me - and Im not being critical - but its interesting to me that the pathology report does not reflect that. ( That being Parklands real reason for ordering the chest tubes. ) The autopsy report said that those incisions were made to combat subcutaneous emphysema which is not a - in the current jargon - a viable therapeutic technique. 1HSCA 309 What Malcolm Perry is saying is that no reputable surgeon would dream of using Chest Tubes to cure subcutaneous emphysema!

So why state something in the Autopsy Report Humes knew to be untrue? The chest tubes had been employed because Perry felt the right lung might have been damaged. It appears that was something Humes did not want in the report.

James

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"I understand that what happened was that after the Autopsy, Commander Humes made two phone calls to Malcolm Perry in Dallas. The first was an exploratory call to see what had been done. It was during this call that Humes was informed about the neck wound. This was when he discovered that what he had thought was a tracheotomy, was indeed one - but also one cut over an existing wound. Something Humes had not been aware of. The second call was quite specific and was about the Chest Tubes. Malcolm Perry referring to this call said he (Humes) subsequently called back and inquired about the chest tubes, and why they were placed and I replied in part as I have here. It was somewhat more detailed. H6 16"

I find it difficult to believe Humes was unaware of the neck wound until informed by Perry over the phone. There are quite accurate descriptions, by autopsy witnesses at Bethesda, of the autopsy doctors pondering whether or not the throat wound had been the result of a piece of shrapnel exiting the cranium.

If Humes phoned Perry a second time to inquire about why Chest Tubes had been placed in the 2nd intercostal space bi-laterally, this proves beyond doubt that Humes lied about one of the key findings of the autopsy. He clearly states in the autopsy report that only shallow incisions (not penetrating beyond the subcutaneous layer) had been made in JFK's anterior chest.

From the autopsy report:

"Situated on the anterior chest wall in the nipple line are bilateral 2 cm.

long recent transverse surgical incisions into the subcutaneous tissue.
The one on the left is situated 11 cm. cephalad to the nipple and the
one on the right 8 cm. cephalad to the nipple."

("cephalad" meaning "toward the head", accurately placing these incisions in the intercostal spaces between the 2nd and 3rd ribs)

How can Humes be inquiring about the placement of chest tubes, and then state in the report that the incisions in the chest were never made deep enough to accommodate the insertion of these tubes?

"When the Autopsy report came to be written, although the use of chest tubes was acknowledged, their purpose had been changed. The report stated that Incisions were made in the upper anterior chest wall bilaterally to combat possible subcutaneous emphysema. CE 387 2 Humes use of language is really interesting. Homes uses the adjective "possible.He knew very well the real reason why the chest tubes had been inserted. However the use of this word covered him and allowed the suggestion to be made that there was an anterior reason why the tubes had been employed. The report did not reflect that the real reason Parkland had decided to use them which was because they feared the right lung had been damaged."

In actuality, James, Humes avoids the use of the term "chest tubes" altogether in the autopsy report. As subcutaneous emphysema is nothing more than trapped air just below the surface of the skin, I believe he attempts to leave the impression, in the report, that these shallow incisions, that did not (according to Humes) go all the way into the pleural cavities, were made solely to release that trapped air. How strange, though, that these incisions would be made in exactly the location (2nd intercostal space, mid-clavicular line) that was traditionally (and still is today) the recommended site for needle decompression of a tension pneumothorax PLUS the location recommended for the insertion of a chest tube, for the continual relief of a tension pneumothorax. It is also extremely strange that Humes would describe the location of the incisions as "in the nipple line" and "cephalad to the nipple" when the rest of the medical community describes the location as "2nd intercostal space at the mid-clavicular line", as if Humes was doing everything in his power to conceal the true nature of the condition of JFK's right lung.

"When Malcolm Perry was interviewed by the HSCA he was asked about the Autopsy reports description of why the Chest Tubes had been used. He replied: Its interesting to me - and Im not being critical - but its interesting to me that the pathology report does not reflect that. ( That being Parklands real reason for ordering the chest tubes. ) The autopsy report said that those incisions were made to combat subcutaneous emphysema which is not a - in the current jargon - a viable therapeutic technique. 1HSCA 309 What Malcolm Perry is saying is that no reputable surgeon would dream of using Chest Tubes to cure subcutaneous emphysema!"

When Perry describes the incisions as "not a viable therapeutic technique" for combating subcutaneous emphysema, I believe what he is actually saying is that, even if JFK had subcutaneous emphysema, it was 1) clearly only a mild case of this condition 2) most definitely NOT life threatening or interfering with JFK's respiration and 3) a "viable" therapeutic technique would be to simply allow the body to re-absorb this air by itself over time, should JFK have survived. It is ironic to note that one of the leading causes of subcutaneous emphysema is the incorrect placement of chest tubes, inserted for the purpose of draining air from the pleural cavity of a patient suffering from tension pneumothorax.

"So why state something in the Autopsy Report Humes knew to be untrue? The chest tubes had been employed because Perry felt the right lung might have been damaged. It appears that was something Humes did not want in the report."

Truer words were never spoken, James. However, while it is tempting to assume Humes' sole purpose in concealing the true nature of the damage to JFK's right lung had everything to do with the attempt to have the back wound connected to the throat wound, bypassing contact with the right lung altogether and thus laying the ground work for the Single Bullet Theory, I personally believe he was being directed to conceal something else as well.

What Humes was being directed to conceal, I believe, was the very odd situation of a full metal jacket, round nosed bullet hitting JFK's back at just over 2000 feet per second, not striking any ribs as it entered his pleural cavity, and not exiting the front of his chest. For such a bullet to come to a stop midway through his right lung would be nothing short of miraculous. Even more miraculous would be for that bullet to come to a stop after only penetrating an inch of the skin of JFK's back.

As I have stated before, there are a limited number of exotic types of bullets capable of doing this, and none of them would have been available to a minimum wage earner at the TSBD in 1963. And, as all clues indicate the same type of exotic bullet(s) caused massive amounts of damage to JFK's skull and brain, it becomes somewhat easier to understand why the true nature of the damage to JFK's right lung had to be concealed.

Edited by Robert Prudhomme

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Robert,

Thanks for posting this nonsense that Humes reported in the autopsy. I was completely unaware of it. It is yet one more inconsistency that LNers should be forced to answer. I wonder how Bugliosi would explain it.

I wonder also what the Parkland doctors thought when they read it. I wish Dr. Perry would have called Humes out on it instead of "not being critical." On the other hand, had he done so the HSCA would have probably buried it.

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Robert Prudhomme wrote:-

"What Humes was being directed to conceal, I believe, was the very odd situation of a full metal jacket, round nosed bullet hitting JFK's back at just over 2000 feet per second, not striking any ribs as it entered his pleural cavity, and not exiting the front of his chest. For such a bullet to come to a stop midway through his right lung would be nothing short of miraculous. Even more miraculous would be for that bullet to come to a stop after only penetrating an inch of the skin of JFK's back.

As I have stated before, there are a limited number of exotic types of bullets capable of doing this, and none of them would have been available to a minimum wage earner at the TSBD in 1963. And, as all clues indicate the same type of exotic bullet(s) caused massive amounts of damage to JFK's skull and brain, it becomes somewhat easier to understand why the true nature of the damage to JFK's right lung had to be concealed."

I am not sure I fully agree, but I believe we need to explore this issue: what was Humes thinking as well as the pressure he was put under.

From what I can see the right lung was seriously compromised. I cannot get passed Humes reply to SenatorCooper's question about what was the character of the bruise.

Commander HUMES. “The bruise here, photographs are far superior to my humble verbal description, but if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura. Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” H2 369

The size of this damage astonishes me. Homes constantly refers to it as a bruise, but what he describes is anything but a bruise. The only explanation I can think about is that a bullet was responsible.

Now whether that bullet went not to the spine is an issue of debate. I am not sure it did, but it is certainly an issue worthy for debate.

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A number of years ago I had had about enough of Humes and his charade so I took a very close look at what he said about the headwound and plotted it on a skull in 2 and 3 dimensions.

The part of the testimony illustrated is presented below and what we find are 3 very distinct lines of injury on what have shown a shot from the front.

Best Evidence proved to me that a craniotomy was in process prior to 8pm. Brains do not fall out of skulls, it's a very complicated procedure to separate brain from the body.

What Humes describes is POST his butchering of the head and is not possible with a single bullet...

Brainandskulldetail-Illustratedwoundsacc

Commander HUMES - Exhibit 391 is listed as a supplementary report on the autopsy of the late President Kennedy, and was prepared some days after the examination.
This delay necessitated by, primarily, our desire to have the brain better fixed with formaldehyde before we proceeded further with the examination of the brain which is a standard means of approach to study of the brain.
The brain in its fresh state does not lend itself well to examination.
From my notes of the examination, at the time of the post-mortem examination, we noted that clearly visible in the large skull defect and exuding from it was lacerated brain tissue which, on close inspection proved to represent the major portion of the right cerebral hemisphere.
We also noted at this point that the flocculus cerebri was extensively lacerated and that the superior sagittal sinus which is a venous blood containing channel in the top of the meninges was also lacerated.
To continue to answer your question with regard to the damage of the brain, following the formal infixation, Dr. Boswell, Dr. Finck and I convened to examine the brain in this state.
We also prepared photographs of the brain from several aspects to depict the extent of these injuries.
We found that the right cerebral hemisphere was markedly disrupted. There was a longitudinal laceration of the right hemisphere which was parasagittal in position. By the saggital plane, as you may know, is a plane in the midline which would divide the brain into right and left halves. This laceration was parasagittal. It was situated approximately 2.5 cm. to the right of the midline, and extended from the tip of occipital lobe, which is the posterior portion of the brain, to the tip of the frontal lobe which is the most anterior portion of the brain, and it extended from the top down to the substance of the brain a distance of approximately 5 or 6 cm.
The base of the laceration was situated approximately 4.5 cm. below the vertex in the white matter. By the vertex we mean--the highest point on the skull is referred to as the vertex.
The area in which the greatest loss of brain substance was particularly in the parietal lobe, which is the major portion of the right cerebral hemisphere.
The margins of this laceration at all points were jagged and irregular, with additional lacerations extending in varying directions and for varying distances from the main laceration.
In addition, there was a laceration of the corpus callosum which is a body of fibers which connects the two hemispheres of the brain to each other, which extended from the posterior to the anterior portion of this structure, that is the corpus callosum. Exposed in this laceration were portions of the ventricular system in which the spinal fluid normally is disposed within the brain.
When viewed from above the left cerebral hemisphere was intact. There was engorgement of blood vessels in the meninges covering the brain. We note that the gyri and sulci, which are the convolutions of the brain over the left hemisphere were of normal size and distribution.
Those on the right were too fragmented and distorted for satisfactory description.
When the brain was turned over and viewed from its basular or inferior aspect, there was found a longitudinal laceration of the mid-brain through the floor of the third ventricle, just behind the optic chiasma and the mammillary bodies.
This laceration partially communicates with an oblique 1.5 cm. tear through the left cerebral peduncle. This is a portion of the brain which connects the higher centers of the brain with the spinal cord which is more concerned with reflex actions.
There were irregular superficial lacerations over the basular or inferior aspects of the left temporal and frontal lobes. We interpret that these later contusions were brought about when the disruptive force of the injury pushed that portion of the brain against the relative intact skull.
This has been described as contre-coup injury in that location.
This, then, I believe, Mr. Specter, are the major points with regard to the President's head wound.

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Robert Prudhomme wrote:-

"What Humes was being directed to conceal, I believe, was the very odd situation of a full metal jacket, round nosed bullet hitting JFK's back at just over 2000 feet per second, not striking any ribs as it entered his pleural cavity, and not exiting the front of his chest. For such a bullet to come to a stop midway through his right lung would be nothing short of miraculous. Even more miraculous would be for that bullet to come to a stop after only penetrating an inch of the skin of JFK's back.

As I have stated before, there are a limited number of exotic types of bullets capable of doing this, and none of them would have been available to a minimum wage earner at the TSBD in 1963. And, as all clues indicate the same type of exotic bullet(s) caused massive amounts of damage to JFK's skull and brain, it becomes somewhat easier to understand why the true nature of the damage to JFK's right lung had to be concealed."

I am not sure I fully agree, but I believe we need to explore this issue: what was Humes thinking as well as the pressure he was put under.

From what I can see the right lung was seriously compromised. I cannot get passed Humes reply to SenatorCooper's question about what was the character of the bruise.

Commander HUMES. “The bruise here, photographs are far superior to my humble verbal description, but if I let my hand in cup shaped fashion represent the apical parietal pleura, it was an area approximately 5 cm. in greatest diameter of purplish blue discoloration of the parietal pleura. Corresponding exactly with it, with the lung sitting below it, was a roughly pyramid-shaped bruise with its base toward the surface of the upper portion of the lung, and the apex down into the lung tissue, and the whole thing measured about 5 cm., which is a little - 2 inches in extent, sir.” H2 369

The size of this damage astonishes me. Homes constantly refers to it as a bruise, but what he describes is anything but a bruise. The only explanation I can think about is that a bullet was responsible.

Now whether that bullet went not to the spine is an issue of debate. I am not sure it did, but it is certainly an issue worthy for debate.

Hello James

I believe Humes was in a serious dilemma regarding JFK's right lung. As it would have been obvious, even to lay observers at the autopsy, that, once it was removed from the chest cavity, there was something quite wrong about the upper portion of JFK's right lung, it was necessary to come up with a story that included this defect, yet seriously downplayed the importance of it. The "bruising" of the apex of the right lung, by a bullet passing near the apex, was produced to mollify any autopsy witness who just happened to remember an oddity about the right lung.

However, as you observed, the damage was far greater than Humes related.

"Dr. PERRY - Yes. Once the transverse incision through the skin and subcutaneous tissues was made, it was necessary to separate the strap muscles covering the anterior muscles of the windpipe and thyroid. At that point the trachea was noted to be deviated slightly to the left and I found it necessary to sever the exterior strap muscles on the other side to reach the trachea.

I noticed a small ragged laceration of the trachea on the anterior lateral right side. I could see the endotracheal tube which had been placed by Dr. Carrico in the wound, but there was evidence of air and blood around the tube because I noted the cuff was just above the injury to the trachea.

I noticed there was free air and blood in the right mediastinum"

"Dr. CARRICO - I believe we were to where the endotracheal tube had been inserted. After this, the President--his respirations were assisted by the Bennett machine. We again listened to .his chest to attempt to evaluate the respirations. Breath sounds were diminished, especially on the right, despite the fact that the endotracheal tube was in place and the cuff inflated, there continued to be some leakage around the tracheal wound"

The two most important observations from the quoted passages of Drs. Perry and Carrico above are:

1) "At that point the trachea was noted to be deviated slightly to the left and I found it necessary to sever the exterior strap muscles on the other side to reach the trachea."

2) "We again listened to .his chest to attempt to evaluate the respirations. Breath sounds were diminished, especially on the right........"

What Perry and Carrico are describing here are the unmistakeable signs of a tension pneumothorax in JFK's right lung.

During a tension pneumothorax, air escapes from the damaged lung into the pleural space surrounding the lung; filling that space and causing the lung to collapse. As the lung is collapsed, breath sounds cannot be heard on this side of the chest, as the lung no longer is filling.

Air trapped in the right pleural space would continue to build in volume and pressure, especially if positive pressure assisted ventilation was provided in the ER. As this air pressure builds, it exerts a lateral force on the other organs in the chest (ie. heart, trachea, left lung), pushing them towards the unaffected lung. The evidence of this can be seen in the deviation of the trachea away from the affected lung, as observed by Perry during the tracheotomy.

There can be no doubt, JFK suffered a grave injury to the top of his right lung, and it was the result of a direct hit from a bullet.

What kind of bullet caused this damage is another question.

Edited by Robert Prudhomme

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while it is tempting to assume Humes' sole purpose in concealing the true nature of the damage to JFK's right lung had everything to do with the attempt to have the back wound connected to the throat wound, bypassing contact with the right lung altogether and thus laying the ground work for the Single Bullet Theory, I personally believe he was being directed to conceal something else as well.

The birth of the 'single-bullet theory' was many months later, but of course a shot from the front was not allowed, and the back wound was too low to serve as an entry wound for the throat "exit" wound. Raising the back wound to correspond with the throat wound solves this problem, but how do you explain the obvious indications of damage to lung/pleura? You state that the pleura was NOT violated. Not even by chest tubes.

As discussed in a long previous thread, a FMJ bullet does not stop an inch or two into soft tissue. Considering the location of the shirt bullet holes and the downward trajectory, the back shot would have transited the lung and exited the chest. A chest exit wound was not observed at Parkland. To me this is proof that JFK was not shot in the back with a standard Carcano bullet.

This leaves two possibilities:

1. The back wound was not caused by a bullet. It was created to prove shots came from behind.

2. The back wound was inflicted by a frangible bullet that damaged the lung and did not exit the body.

Was this back wound observed prior to JFK's body departing Parkland? If so, then it is real.

Dr. James Carrico checked JFK's back for wounds. In his testimony he clearly states that the body was raised enough for him to FEEL the back. He further states that at no time did he look at JFKS's back as this was an emergency examination. He later states that he was looking for LARGE wounds only. He repeats this statement. According to him, with all the blood and debris a small wound was unlikely to be detected. In a passage that appears to have been edited he states "There could have been a back wound."

Several members have pointed out to me that the nurses testified that they did not see a back wound. During testimony, the two nurses were NEVER asked if they saw the back wound when they washed the body. They were asked if they saw it when JFK was removed from the limo. Many years after the assassination Diana Bowron stated that she DID see the back wound. Due to the elapsed time, this is not positive proof, but is evidence favoring an actual back wound.

SS Glen Bennett stated that he observed the impact of a bullet in JFK's back. Per his written statement made on the plane returning to DC from Dallas he recorded this observation. SS Paul Landis stated that upon boarding AF-1 he broke down in tears. He wished he could have the self-control of Glen Bennett who at this time was calming recording his observations on paper. Not positive proof that GB saw what he says he saw, but this is supporting evidence.

Per the above, insufficient evidence exists to entirely eliminate either of these two possibilities. Is there medical evidence supporting a real back wound? Yes. There is ample evidence that the pleura was violated, and not necessarily via the throat wound. If the back wound is real, then it MUST have penetrated the pleura and damaged the lung without exiting the chest. This could occur only with a frangible bullet which would eliminate LHO as the assassin -- an even more powerful reason to deny a penetration of the pleura than the throat wound.

Edited by Tom Neal

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Hi Tom

Thanks for placing things in perspective. Do you know if the date at the end of the autopsy report, 06/12/63, is the date Humes finished the autopsy report? The reason I ask is this is only two weeks after the assassination, and it seems like the ground work is already being laid for the SBT.

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Robert,

There are two issues that bother me. First is the damage to the Lung. The second is the damage to the spine.

Xray taken before the autopsy:-

X-AUT-9.png

I have added lines to show the clear slope of the neck. Clearly there has been damage to the spine. This image and close up taken around 8:30pm and after the organs have been removed makes clear something has been damaged. the position of the damage is around C7.
X_AUT_8.png
The question is this. Did a bullet enter through the throat hit and damage the spine around C7 and land on the lung thereby creating the damage to the lung? Something caused that damage to the spine. The kind of damage needs explaining. And the only explanation I have is that the spine was damaged by a bullet entering through the throat. I wonder whether this same bullet did not also cause the damage to the lung.

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Hi Tom

Thanks for placing things in perspective. Do you know if the date at the end of the autopsy report, 06/12/63, is the date Humes finished the autopsy report? The reason I ask is this is only two weeks after the assassination, and it seems like the ground work is already being laid for the SBT.

Bob,

Great job on this thread!

IMO December 6, 1963 is the date that Stover and Galloway signed Humes completed report.

Do you think that the tension pneumothorax was caused entirely by damage to the top of the lung from the throat entry shot or damage from the back entry shot?

Thanks for any thoughts,

Tom

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Robert,

There are two issues that bother me. First is the damage to the Lung. The second is the damage to the spine.

Xray taken before the autopsy:-

X-AUT-9.png

I have added lines to show the clear slope of the neck. Clearly there has been damage to the spine. This image and close up taken around 8:30pm and after the organs have been removed makes clear something has been damaged. the position of the damage is around C7.
X_AUT_8.png
The question is this. Did a bullet enter through the throat hit and damage the spine around C7 and land on the lung thereby creating the damage to the lung? Something caused that damage to the spine. The kind of damage needs explaining. And the only explanation I have is that the spine was damaged by a bullet entering through the throat. I wonder whether this same bullet did not also cause the damage to the lung.

Hi James

It has been noted in several places that JFK had, for many years, been suffering from osteoporosis of the cervical vertebrae. This was a direct result of the Addison's disease he was diagnosed with when he was 30 years old. It is a little known fact that, when he was properly diagnosed, JFK was given no more than a year to live. Deterioration of cervical vertebrae, and the subsequent collapsing of discs, would also explain the apparent stooped neck JFK seemed to display while sitting in the limo.

"Osteoporosis is more common among people with Addison's disease compared to healthy individuals because of the medical management with long-term steroid replacement therapy. Steroids have several effects on bones including increasing osteoclastic activity, decreasing osteoblastic formation, and decreasing the absorption of calcium in the intestines."

http://www.physio-pedia.com/Addison's_Disease

Addison's disease also explains why JFK always looked so well tanned.

"President John F. Kennedy is the most widely known person who was believed to have suffered from Addison's disease, easily noting the bronze coloring of his skin in photographs. Prior to diagnosis, he was so ill that he collapsed during his final campaign event for the House of Representatives, being described as "sweating heavily and his skin being discolored." When he was properly diagnosed, doctors gave him the prognosis of no more than a year to live.

Some of the clinical signs and symptoms of Addison’s disease include:

Darkened pigmentation of the skin (especially of the mouth and scars), due to increased secretion of melanin-secreting hormone (MSH) corresponding with increased secretion of ACTH, which is released to try to stimulate the work of the adrenal glands."

Are we looking at damage from a bullet at C6/C7, or are we looking at bone deterioration from osteoporosis?

Edited by Robert Prudhomme

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Hi Tom

Thanks for placing things in perspective. Do you know if the date at the end of the autopsy report, 06/12/63, is the date Humes finished the autopsy report? The reason I ask is this is only two weeks after the assassination, and it seems like the ground work is already being laid for the SBT.

Bob,

Great job on this thread!

IMO December 6, 1963 is the date that Stover and Galloway signed Humes completed report.

Do you think that the tension pneumothorax was caused entirely by damage to the top of the lung from the throat entry shot or damage from the back entry shot?

Thanks for any thoughts,

Tom

I have a slightly different perspective of JFK's bullet wounds than everyone else, it seems.

I carefully read Lt. Richard Lipsey's deposition to the HSCA in which he described his observations of the autopsy of JFK, and the comments of Humes, Finck and Boswell. One of the things he described, which also inspired me to seek evidence of a pneumothorax, was that the doctors spent a great part of the autopsy looking for a bullet that entered JFK's back and ranged downwards, due to the angle of the shot, into his chest or abdomen. Of course, no bullet was ever found.

The other notable thing Lipsey observed was that the autopsy doctors seem to have decided the bullet, or a part of it, that entered near the "external occipital protuberance" had made the wound in the throat as it exited. If you look at this x-ray below, you can see how low in the base of the skull the EOP is. If we consider this, plus the slight lean forward at z313, plus the steep angle of the shot from the 6th floor, it is conceivable that a part of this bullet (or even the entire bullet) merely grazed the base of JFK's skull, and continued on to strike his cervical vertebrae.

35670220.jpg

External occipital protuberance marked with arrow

Also interviewed by the HSCA was Jerrol Custer, the x-ray technician who took all of the x-rays at JFK's autopsy. Custer told the HSCA that the x-ray he recalled seeing of JFK's neck showed "many fragments" in the vicinity of cervical vertebrae C3/C4. Looking at the x-ray above, C3/C4 would align quite well with the path of a bullet deflecting off of the EOP.

Could a frangible bullet have come apart at C3/C4, and a particle of it have continued on to exit JFK's throat?

Edited by Robert Prudhomme

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Do you think that the tension pneumothorax was caused entirely by damage to the top of the lung from the throat entry shot or damage from the back entry shot?

The other notable thing Lipsey observed was that the autopsy doctors seem to have decided the bullet, or a part of it, that entered near the "external occipital protuberance" had made the wound in the throat as it exited.

Jerrol Custer...told the HSCA that the x-ray he recalled seeing of JFK's neck showed "many fragments" in the vicinity of cervical vertebrae C3/C4...would align quite well with the path of a bullet deflecting off of the EOP.

Could a frangible bullet have come apart at C3/C4, and a particle of it have continued on to exit JFK's throat?

A fragment exiting the throat could explain the small size (even for an entry shot) of this wound, but I'm still on the fence regarding an EOP entrance. Could a shot from the front enter the throat and cause the damage at C3/C4? Would this path pierce the pleura and/or lung? If not, then a back shot would be required to cause the tension pneumothorax which I am convinced did exist.

Do you think your EOP entrance/throat exit is the most likely explanation for the 'throat wound'?

Tom

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Do you think that the tension pneumothorax was caused entirely by damage to the top of the lung from the throat entry shot or damage from the back entry shot?

The other notable thing Lipsey observed was that the autopsy doctors seem to have decided the bullet, or a part of it, that entered near the "external occipital protuberance" had made the wound in the throat as it exited.

Jerrol Custer...told the HSCA that the x-ray he recalled seeing of JFK's neck showed "many fragments" in the vicinity of cervical vertebrae C3/C4...would align quite well with the path of a bullet deflecting off of the EOP.

Could a frangible bullet have come apart at C3/C4, and a particle of it have continued on to exit JFK's throat?

A fragment exiting the throat could explain the small size (even for an entry shot) of this wound, but I'm still on the fence regarding an EOP entrance. Could a shot from the front enter the throat and cause the damage at C3/C4? Would this path pierce the pleura and/or lung? If not, then a back shot would be required to cause the tension pneumothorax which I am convinced did exist.

Do you think your EOP entrance/throat exit is the most likely explanation for the 'throat wound'?

Tom

Well, I don't necessarily pick one theory and kick all the others to the curb. The throat wound could just as easily have been caused by a frontal shot as from one striking the EOP. Without access to any real evidence, we are all just making educated guesses.

However, for a bullet or fragment to strike the cervical vertebrae and then go into the right lung requires it to make an almost 90° turn downward. With all the indications that the back wound was at the level of thoracic vertebra T3, I believe the back wound was the more likely source of the pneumothorax, as this diagram demonstrates:

posterior_lungs1341270126571.jpg

Note that a bullet entering at the level of T3, between the spine and the right scapula, would go directly into the apex of the right lung.

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